Provider Demographics
NPI:1952900805
Name:VASILIAUSKAS, JUSTINA (OD)
Entity Type:Individual
Prefix:DR
First Name:JUSTINA
Middle Name:
Last Name:VASILIAUSKAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JUSTINA
Other - Middle Name:
Other - Last Name:VASILIAUSKAITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:823 SE 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-5866
Mailing Address - Country:US
Mailing Address - Phone:561-313-5197
Mailing Address - Fax:
Practice Address - Street 1:2000 PALM BEACH LAKES BLVD STE 400
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6504
Practice Address - Country:US
Practice Address - Phone:561-500-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC5587152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist